- "We see only the tip of the iceberg of XDR-TB"
- warns Doctors without Borders
- TB+HIV epidemics worsened by a very severe health worker
shortage in SAfrica...'
- June 22 2007 - Dr Eric Goemaere, head of Doctors without
Borders in South Africa, issued an urgent call late last year to health
workers worldwide over Voice of America radio broadcasts to sign up for
jobs there. He warned that due to the "very severe" shortage
of doctors and nurses at their clinics treating co-infected TB+HIV patients,
many now have to forego treatment and new patients cannot be diagnosed.
- Hear his Voice of America broadcast on:
- 3 to 6-million people co-infected with TB+HIV in South
Africa will die of XDR-TB
- "We can try to control the damage that we see today
from drug- resistant TB," Dr. Goemaere said on June 21 2007. "But
we are only seeing the tip of the iceberg". He spoke in reaction
to the World Health Organisation's new plan to contain drug-resistant
- Read The Plan:
- South Africa has the largest number of people with Hiv-Aids
in the world, with about six million people infected -- and 60% (3.6-
million) of those people also are co-infected with TB+HIV, according to
Dr Goemaere's clinical findings.
- This co-infection becomes progressively untreatable with
any available drugs and ultimately leads to their deaths from Extremely-
Drug-Resistant Tuberculosis. (XDR-TB)
- In South Africa, their death is hastened even more with
the uniquely South African strain of XDR-TB called SA-1, which is a mutation
of the tuberculosis bacillus and the human-immune- deficiency virus.
- Patients with the SA1 strain are seen to die within 20
to 25 days according to the World Health Organisation.
- Listen to NPR radio's interviews with South African doctors
at two TB-hospitals in Nov. 2006:
- In 1999, Doctors without Borders set up their first integrated
clinic to address the co-infection of tuberculosis plus the Aids- virus
at the gigantic Ubuntu clinic in the large Khayelitsha township about
30km from Cape Town. They also opened another clinic in Lusikisiki in
the Eastern Cape.
- 120-year-old sputum test:
- The diagnostic tools and treatments remain limited and
archaic, Doctors without Borders warn.
- "To diagnose Tuberculosis, we still rely on the
microscope examination of sputum, a method developed more than 120 years
ago and that only allows the detection of 45-65 percent of cases.This
rate is even lower for patients infected by both HIV and TB," says
Nobel Peace Prize laureate Dr. Marie-Eve Raguenaud, a TB specialist with
- "Due to the limitations of the test, the treatment
of half the patients in developing countries is often delayed or not started
at all," she warns.
- Read her call to also include children in TB-diagnosis:
- In a struggle to find a new user-friendly and more efficient
diagnostic tool, MSF is developing new tests, by evaluating the viability
of new technologies on its field operations. 'While waiting for a rapid
and efficient diagnostic test, MSF teams also consider new methods to
simplify clinical TB diagnostic in children' highlights Dr Raguenaud.
'Also diagnosing children at the health centre level, (instead of just
adults) and not only by a doctor at the hospital, would allow the detection
of more cases'.
- TB+HIV patients get 13 - 16 pills a day with serious
- Regarding treatment, it already is very difficult for
TB patients but gets even worse for patients co-infected with HIV/AIDS.
- "These patients have to take between 13 and 16 pills
a day. Also, there are interactions between AIDS and TB treatment which
cause side effects like liver problems or allergies," highlights
Dr. Van Cutsem who coordinates one of MSF's programs in South Africa.
- Full report on the severe health worker shortage in
- The report covers four southern African countriesLesotho,
Malawi, Mozambique and South Africa:
- Address: Doctors without Borders/Medicins Sans Frontieres
- 333 7th Avenue, 2nd Floor
- New York, NY 10001-5004
- By Phone (212) 679-6800
- By Fax (212) 679-7016
- By Email: email@example.com
- Michael Goldfarb Press Officer
- Telephone Direct: USA (1) (212) 763-5783